Download Professor Chris Evans, Group Chairman, Excalibur

Excalibur Healthcare
Private and confidential
Excalibur
• World class track record in medical infrastructure and investments over 30 years
• Created over 50 medical and health companies from scratch worth over $5bn
• IPO’d 21 companies on worlds stock market
• Constructed 270 different laboratories/clinics
• Built over 65 office buildings and premises for own companies
• Built over 40 advanced manufacturing facilities and production plants
• Raised >$2bn for cancer research in 40 areas of cancer
• Over 200 new medicines in development
• Over 20,000 patients in clinical trials
• In 1996 Sir Chris first entrepreneur to develop new stem cell technology in
Europe
$5 Billion of Value by Sir Chris Evans and Excalibur Team
Company
Date
Chiroscience PLC
2003
$1.0m
$1,000m
BioVex Inc
2011
$2.0m
$1,000m
Vectura PLC
2008
$1.5m
$1,100m
Ark Therapeutics PLC
2007
$2.0m
$560m
Piramed Limited
2009
$0.5m
$200m
Neurotech
2011
$0.5m
$165m
Arakis PLC
2005
$0.4m
$160m
Celsis International PLC
2008
$0.3m
$150m
Santhera AG
2007
$5.0m
$125m
Plethora PLC
2007
$0.1m
$120m
Wilex AG
2007
$7.0m
$120m
Noxxon AG
2011
$6.0m
$120m
ReNeuron PLC
2006
$1.0m
$100m
Cyclacel Inc
2003
$3.0m
$90m
Neuropharm PLC
2007
$0.2m
$75m
Microscience Limited
2006
$1.0m
$65m
Toad PLC
2000
$0.1m
$65m
Virgin Health Bank Limited
2010
$2.0m
$45m
Derms Development Limited
2007
$4.0m
$45m
Energist Limited
2010
$5.0m
$35m
Destination Skin Limited
2008
$3.0m
$35m
Cambridge Biotechnology Limited
2007
$0.5m
$25m
$46.1m
$5,500m
TOTAL
Initial Value
Peak Value
Leadership
EHC is led by Professor Sir Christopher Evans OBE, Europe’s foremost biosciences,
medical and healthcare entrepreneur who has:
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Advised four UK Prime Ministers on biomedical and healthcare policy
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Chaired the EU “BEST” Taskforce overseeing 19 million small businesses across
the European Union
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Advised the governments in London, Wales, Denmark, Finland, Malta and
Qatar
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Led the creation and growth of several billion dollars’ worth of advanced
medical companies
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Built this team of UK experts to provide medical facilities and services, to
advise on setting health care policy and a long-term strategy for healthcare
needs.
Core Consortium Members
Globally Recognised UK Based Health Experts
The Excalibur Healthcare Consortium
• Extensive experience in healthcare facilities construction and management
• Delivered over 2500 hospitals, labs, clinics and other healthcare infrastructure globally,
including:
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Primary Healthcare Centres
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General and Acute Hospitals
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Specialist and Tertiary Hospitals
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Mental Healthcare Facilities
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Medical Research Facilities
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Specialist Training Facilities
• Includes some of the UK’s finest medical experts and practitioners – Royal Colleges, NHS
Trusts, leading Universities and Medical Schools.
• Enjoys the full support of the UK government through co-operation with UK Trade and
Industry (UKTI) and Healthcare UK.
The EHC Offering
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Hospital management and operation
Staffing – clinical, technical, support and management staff
Strategic direction - improved patient care and outcomes, system efficiencies
Mobile primary health care facilities
Trauma & rehabilitation
Training and education
Modular hospitals
Refurbishment of existing healthcare facilities
Conversion for healthcare use
Permanent hospitals
State of the art mobile hospitals
Medical equipment and pharmaceutical supplies, supply chain management
Impact
• Improved patient outcomes
• Consistently applied protocols and practices
• Clinical delivery to highest UK standards
• Operational and management efficiency
• Sustainability through training and education
• Continuing development of local staff
Ground Breaking Therapy
ReNeuron plc
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Clinical-stage, UK-based cell therapy business
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Highly scalable stem cell expansion technology – off-the-shelf (allogeneic) cell
therapy candidates
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Principal therapeutic programs target:
 stroke disability
 critical limb ischaemia
 retinitis pigmentosa
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Leading position in exosomes
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Formed and financed 13 years ago by Prof. Sir Chris Evans
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Led transformative fund raise in summer 2013
Private and confidential
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BioVex
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BioVex Inc
$1 Billion
Medical Technology
Cash Raised by Sir Chris and Team
for Cancer Research
$2.0 billion
Cancer – A Global Disease
 There are over 150 million people living today with cancer
 There are over 200 different types of cancer and 1 and 3 people on earth will be
struck by cancer within their lifetime
 Every year, nearly 10 million people die of cancer and every year there are nearly 15
million new cases of the disease
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1 in 4 of all British deaths are from cancer
 During the lifetime of this existing global population over 2,000 million people will at
some stage have had cancer
Cancer must be controlled
Private and confidential
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Cancer - A Commanding Speciality
Best elements from the finest Cancer institutions around the world:
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Early screening using modern imaging techniques and molecular pathology
Rapid diagnosis supported by excellent radiological opinion
Ground-breaking therapies, radiology and outpatient chemotherapy delivery
“Distributed clinic” model:
• national centres of excellence;
• local cancer centres, clinics, and mobile clinics
• UK leading institutions:
• second opinions, knowledge transfer, support and training
Private and confidential
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Countries with National Cancer Plans
Source: UICC
Private and confidential
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Cancer in Algeria
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Fourteen regional cancer registries covering 37.7% of population
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Existing valuable data
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Top cancer types identified
Male
Female
Lung
Breast
Colon-rectum
Colon-Rectum
Prostate
Thyroid
Hematopoietic
Cervix
Bladder
Ovaries
• A well researched comprehensive National Cancer Plan (NCP) in place
Private and confidential
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Cancer – Key Areas of Improvement
The NCP has identified key areas of improvement
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Equity
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Patient experience
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Surveillance
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Prevention
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Screening
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Diagnosis
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Therapy
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Palliative care
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Support Organisations
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Regulation
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Training
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Research
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Communication
Private and confidential
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Cancer Plans – Need to be Implemented
• The National Cancer Plan puts Algeria in top 20 countries with focus on Cancer
Care
− Great recommendations and findings
• Only top five countries have actually invested in cancer care consistently over many
years in an attempt to implement their plans, with mixed results
− USA
− UK
− Sweden
− Canada
− Australia
Challenge: How to short circuit 10 years of talking / planning / meetings and start
taking action NOW
Private and confidential
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Optimal Implementation Process
High Level Plan for Development of Cancer Services
Key Actions
Diagnostic to define and assess needs of the health economy
Agree principles of early deployment of facilities and cancer services to have a visible impact on
the care of patients
Roll out mobile diagnostic facilities (wet lease) - example breast screening units, mobile clinics to
take cervical smears
Build diagnostic facilities in the communities - increase capacity within the CAC rapidly to
improve early detection rates
Design World Class Cancer Centre drawing from experience for similar institutions
internationally
Build World Class Cancer Centre that will deliver complete range of high tech diagnostics and
specialised therapy. This will form the basis of a hub and spoke model.
Deploy World Class Cancer Centre - provides specialised care for a wide range of complex cases
with the latest in diagnostics and treatment
Procure Staffing for Cancer Centre - specialist pathologists, radiologists, radiographers, surgeons
and other support personnel. Potentially internationally to build capacity.
Build Therapy Centres - Radiotherapy - existing 7 projects that need to be completed
Design Population Surveillance for ongoing information of changing demographic and incidence
patterns
Develop and Deploy Population Surveillance with appropriate IT support allowing information
analysis and data mining
Design Screening Programmes - for specific conditions such as cervix, breast, bowel, colo-rectal
cancers
Roll out Screening Programmes - for specifc conditions such as cervix, breast, bowel, colo-rectal
cancers
Annual review of surveillance and screening
Define national requirements for additional specialised hospitals, diagnostic centres and
therapy clinics
Develop local clinica - polyclinics, diagnostic facilities
Develop post treatment support - after care, rehabilitation following complex surgery
Develop and deploy palliative care - for end of life care patients, residential facilities away from
hospital
Build and deploy additional diagnostic facilities - specialised centres that provide pathology,
radiology and in certain cases cytogenetics
Build and deploy additional therapy facilities - Radiotherapy units, day case units that can
provide chemotherapy drugs as day patients
Develop Cancer Networks - to facilitate expert opinions, rapid decisions on diagnosis and
management and knowledge sharing
Develop existing diagnostic departments (histopathology) - increase the capacity and capability
through training of various staff and recruitment of trained staff
Understand training needs of various groups of staff such as doctors, primary care physicians,
paramedics, radiographers.
Develop & Deploy training programmes for undergraduates
Develop & Deploy training programme for professionals (medical/paramedical/technical)
Develop and implement regulatory frameworks - to support prevention programmes for
environmental, lifestyle and occupational risks
Develop Research Plans
Design and build Research facilities including modern facilities for cyto genetic research
Conduct research - existing facilities - large teaching hospitals and specialist centres
Operate new research facilities - research into the management of cancers with international
cooperation and collaboration
Private and confidential
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4-6
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13 - 15
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Time Line – Months
22 - 24 25 - 27 28 - 30
31 - 33
34 - 36
37 - 39
40 - 42
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46 - 48
49 - 52
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Meeting the Challenge – Immediate Steps
Build cancer network to
make available nationally
Early screening
Rapid diagnosis
Access to treatment
Distributed clinic model
Cancer centres
Local clinics
Mobile clinics
Multidisciplinary
teams
Private and confidential
Best-in-class
equipment
Ground-breaking
therapies
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Distributed Clinic Model
C
C
M
M
Cancer Centre
• Comprehensive cancer care
• Best in class
• Referral from local clinics
C
Cancer
Centre
C
C Local Clinics
Cancer
Centre
Algerian
Cancer
Council
Cancer
Centre
Private and confidential
Cancer
Centre
• Screening / diagnosis
• Treatment
M Mobile Clinics
• Screening / diagnosis
• Treatment
Cancer
Centre
Linked to leading UK
Cancer Institutions
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Best-in-Class Cancer Centres
Peter MacCallum Cancer Institute, Melbourne (cgi)
Karolinska Institute
Oxford Cancer Centre, Churchill Hospital
Memorial Sloan Kettering,
New York
Private and confidential
Guys and St Thomas’ Cancer Centre
London (cgi)
Mayo Clinic, Rochester
Local Cancer Clinics – screening, diagnosis, treatment
Jackson County, Oklahoma
Billings, Montana
Oxford Day Centre, Perth
Cabrini Centre, Melbourne
Ozark, Missouri
Private and confidential
Beatson West of Scotland
Cancer Centre
Cabrini Centre, Melbourne
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Cancer Centres: The Excalibur Model
Each cancer centre will have:
• Rapid on site screening and diagnostics − Modern imaging techniques and molecular pathology
− Clinical decision-making supported by excellent radiological opinion
• World-class branded clinical and outpatient chemotherapy delivery − Delegation of responsibility to highly trained chemotherapy nurses
− Support from oncology pharmacists
− Molecular markers to improve precision of cancer treatment
• Multidisciplinary team working to advanced guidelines and SOPs
• Portable electronic patient data linked to national network
• International second opinion service through link to Oxford Cancer Centre
• Clinical Trial infrastructure
Private and confidential
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Advanced Infrastructure needed in the future
Crick Institute (proposed)
RadioImmuno targeting
Lund Sweden
Rinecker Proton Therapy Centre Munich
Private and confidential
Brooks-Wilson Genome Sciences Lab,
British Columbia
National Cancer Institute
Rockville Maryland
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Highly Advanced Mobile Screening
Prostate
Breast
Mobile mammogram units
Private and confidential
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Nationwide Coverage via Mobile Treatment
Protate
Mobile Chemotherapy Units
Private and confidential
Mobile Radiation Therapy Units
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Delivering Best in Class Cancer Patient Pathways
• Co-develop global/local cancer care pathways & guidelines and protocols &
multidisciplinary teams
• Train and build capacity - clinic doctors/nurses/pharmacists
• Telehealth services for diagnostic (complex cases, 2nd opinion) and training
purposes with UK institutions
• Develop cancer database (clinical outcomes)
• Develop patient reported outcome measures (PROMs)
• Develop app-based technology for side effect management, follow up etc
• Patient education – wellness, nutrition, symptoms & treatment
• Patient support and well being
• Cancer prevention programs
• Stratified analysis
Private and confidential
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Breast Cancer - Diagnosis
Mammography - Royal Marsden Hospital, London
Lauder Breast Cancer Centre, Sloan Kettering
Mammography, Toronto
Private and confidential
Breast MRI Scan
Cancer Research, London
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Breast Cancer – Treatment
Radiation Treatment UHN Toronto
Endocrine Therapy
Chemotherapy suite
Private and confidential
Lumpectomy, Mastectomy
Conservation Surgery
Adjuvant Systemic Treatment
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Diagnosis
Lung Cancer - Diagnosis
CT Scan
Royal Marsden Hospital, London
Chest X-ray,
Oxford University Hospitals, UK
Private and confidential
Sputum Cytology, Pathology laboratory,
Princess Margaret Cancer Centre, Canada
Bronchoscopy,
Henry Ford Hospital, Detroit, USA
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Lung Cancer – Treatment
Robotic Lobectomy (surgery),
Toronto General Hospital, Canada
Chemotherapy, Targeted Drug Therapy,
Royal Free Hospital, UK
Private and confidential
Radiotherapy,
Peter MacCallum Cancer Centre, Australia
Stereotactic Body Radiation Therapy (SBRT)
Stanford Clinical Cancer Centre, USA
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Diagnosis
Colorectal Cancer - Diagnosis
Endoscopy,
Memorial Sloan Kettering Cancer Centre, USA
Virtual Colonoscopy (CT scan),
Guys’s & St Thomas’ Hospital, UK
Private and confidential
Fecal Occult Blood Test
Fecal Immunochemical Test
Flexible Sigmoidoscopy
Odette Cancer Centre, Canada
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Colorectal Cancer – Treatment
Transanal endoscopic microsurgery- rectal tumor,
Massachusetts General Hospital, USA
Chemotherapym, Targeted Drug Therapy,
John Hopkins Cancer Centre, USA
Private and confidential
External Radiotherapy,
Addenbrooke’s Hospital, Cambridge, UK
Colostomy
Churchill Hospital, Oxford, UK
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Specific Infrastructure Requirements
• Build / set-up comprehensive cancer centres
• Build / set-up network of local cancer clinics
• Provide mobile clinics for screening, treatment and palliative care
• Provide specialist equipment for radiotherapy, CT, PET, MRI, X-ray, US,
Endoscopy, etc
• Supply cancer drugs
• Build immunological and molecular analysis facilities
• Build nursing homes, residences and/or hospices
• Provide eHealth tools for patient support and data
Private and confidential
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Detailed Manpower Requirements
Histopathologists
930
Radiologist
1700
Haematologist
635
Palliative Care Physicians
215
Diagnostic radiographers
8400
Therapeutics radiographers
1515
Medical physicist
865
Based on current assumptions, not necessarily exhaustive.
Private and confidential
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A Modern Cancer Plan
• Cancer Centres: 4
• Cancer Clinics: 8-12
• “Hub & Spoke” clinical model –
fixed & mobile
• Program budgeting
• Tele-Health assessment
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National Cancer
Network
National Cancer Strategy
Clinical guidelines
Standardisation
Clinical outcome analysis
Need & benefit analysis
Cancer database
Structure &
Governance
World
Class
Cancer
Care
• Multi-disciplinary teams
• Translational Medicines
• Diagnostic & therapeutic
equipment – fixed & mobile
• Access to Expert Network / Key
Opinion Leaders
Infrastructure &
Manpower
Equitable & Quality
Patient Care
• Clinical Pathway Redesign
• Screening, diagnosis &
treatment
• Mitigation of risk
• Active management
• Living with and beyond cancer
• Sharing community
experience
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Investment
Private and confidential
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Professor Sir Christopher Evans OBE
DSc, PhD, BSc, ARCS, F.Med.Sci, FR Eng, FRSC, FRSA, FIBiol, FIOM, CCMI, C.Biol., CSci, C.Chem